The Rational Clinical Examination
David L. Simel, Drummond Rennie
Alan N. Barkun, Steven A. Grover, Andrew Muir
"A 34-year-old man has complained of fatigue and abdominal pain.
He presents to the emergency department with vague abdominal pain
and fever. The medical history is also that of intermittent sweats
and some weight loss. Your examination reveals diffuse adenopathy.
Traube space is dull to percussion. You decide to try to palpate
the spleen edge but, despite spending a few minutes examining the
patient while he is supine and then while he is on his side, you
decide that you cannot feel the spleen. According to your findings,
how confident should you be that the spleen is not enlarged? ..."
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